Proficiencies in Practice How Students and Assessors Work Together

Helen Arkwright

Alright, welcome back to BPP Nursing Conversations. Today, we’re diving into the nuts and bolts of NMC proficiencies in practice—what they are, how they’re different from Trust competencies, and how everyone—students, assessors, and universities—fits into the picture. Chloe, do you want to kick us off with some definitions?

Chloe Patel

Yeah, sure! So, NMC proficiencies are basically the national standards set by the Nursing and Midwifery Council. They’re what every student nurse has to achieve to register as a nurse. You’ll find them all listed in your Practice Assessment Document, or PAD. Trust competencies, on the other hand, are more about what’s needed for qualified staff in a specific NHS Trust—so, like, local policies or job-specific skills. As a student, you’re not expected to complete those, just the NMC proficiencies.

Helen Arkwright

That’s right, Chloe. And just to add, your practice placement is where you get to apply your knowledge, learn key skills, and work towards those NMC proficiencies under supervision. It’s a partnership—students, practice assessors, academic assessors, and the university all have a role. The tripartite relationship is really important here. The practice assessment document is the main tool we use to record progress and evidence achievement. I remember supporting a first-year student who was really confused about the difference between Trust competencies and NMC proficiencies. We used formative assessment—so, just checking in and having open discussions—to clarify what was actually required for her course, not just what the Trust expected from its staff. It made a huge difference to her confidence.

Chloe Patel

And from the practice assessor side, I always tell students: your PAD is your guide. If you’re ever unsure, ask your mentor or your academic assessor. We’re here to help you focus on what you need for registration, not get lost in extra requirements. The university, the Trust, and you as a student all have responsibilities, but the main thing is communication and making sure everyone’s on the same page.

Helen Arkwright

Exactly, Ahmet. And just to echo that, the university’s job is to make sure placements meet the right standards, and that students have the support they need. It’s all about working together so you can get the most out of your placement and achieve those proficiencies.

Chloe Patel

So, let’s talk about what happens if you can’t actually demonstrate a skill directly on placement. I mean, sometimes Trust policy means you’re not allowed to do something, or maybe there just isn’t the opportunity. What then?

Chloe Patel

Good question, Chloe. The NMC standards are clear that assessment doesn’t always have to be direct demonstration. We can use simulation, reflective discussion, or case studies. For example, if you can’t perform a skill because of policy, we might set up a simulation or talk through a scenario in detail. The important thing is that you can explain the process, the reasoning, and the aftercare. That’s still evidence of proficiency.

Chloe Patel

Yeah, I had that exact situation last year. I couldn’t do a certain procedure, but I had a reflective discussion with my assessor. I explained what I’d do, why, and how I’d keep the patient safe. My assessor signed me off because I’d shown I understood it, even if I couldn’t do it hands-on.

Chloe Patel

That’s a great example, Chloe. And it’s so important for students to know that these alternative methods are valid. The PAD should clearly record how you’ve demonstrated the proficiency—whether it’s through observation, simulation, or discussion. Practice and academic assessors work together, sharing feedback and evidence, to make sure the assessment is objective and fair. It’s not just a tick-box exercise; it’s about making sure you’re genuinely ready for practice.

Helen Arkwright

And just to add, the collaboration between practice and academic assessors is key. We schedule regular points to review progress, share observations, and agree on what evidence is needed. If you’re ever unsure what to record in your practice assessment document, ask! It’s better to have too much detail than not enough. The goal is to show how you’ve met the standard, even if the route is a bit different.

Helen Arkwright

Exactly, helen. And remember, the NMC expects us to be flexible and innovative in assessment, as long as it’s robust and evidence-based. So don’t worry if you can’t do something directly—there’s always another way to show your learning.

Helen Arkwright

Now, sometimes students hit a bump and struggle to meet a proficiency. That’s where support and action plans come in. If you’re finding something difficult, the first step is to talk to your assessor or academic link. We’ll work together to create an action plan—looking at what’s holding you back, what adjustments might help, and how we can support you to progress. The earlier you raise a concern, the easier it is to help.

Chloe Patel

Absolutely, Helen. I had a student recently who was struggling with a particular skill. Because she spoke up early, we were able to put an action plan in place—extra practice, more feedback, and regular check-ins. She ended up passing with flying colours. The process is there to support you, not to catch you out.

Chloe Patel

And what if you see something unsafe on placement? Like, if you’re worried about patient care or staff behaviour?

Helen Arkwright

That’s a really important question, Chloe. If you witness unsafe practice, you have a professional duty to raise your concern. Every Trust and university has a policy for this, and you’ll be supported if you speak up in good faith. The NMC and RCN both say there should be a no-detriment environment—meaning you won’t be penalised for raising concerns. Talk to your mentor, your academic assessor, or use the formal channels if needed. It’s about keeping everyone safe, including you.

Helen Arkwright

And we’ll work with you and the university to address it quickly, making sure your learning continues safely. It’s all about open communication and knowing you’re not alone if something goes wrong.

Chloe Patel

So, just to wrap up—your PAD is your main evidence for NMC registration, and NMC proficiencies are different from Trust competencies. If you can’t demonstrate a skill directly, there are always alternative assessment methods. And remember, your academic assessor should always be your first point of contact if you need support or have concerns.

Chloe Patel

Thanks for listening to BPP Nursing Conversations. There’s always a way to meet every proficiency, and you’re never on your own.

Chloe Patel

It’s been great chatting with you all. Don’t hesitate to reach out if you need help on placement.

Helen Arkwright

We’re here to support you every step of the way. Take care, everyone.

Chloe Patel

Thanks, Helen, Ahmet, Chloe—and thanks to everyone listening. See you next time on BPP Nursing Conversations!